acyclovir and Common-Variable-Immunodeficiency

We report a challenging case of an atypical presentation of recrudescent herpes simplex virus infection in a patient with common variable immunodeficiency. Oral infections in immunosuppressed patients may present with unusual clinical features that can mimic non-infectious diseases. This report discusses the diagnostic steps necessary for definitive diagnosis and to guide appropriate and effective management.

Topics: Acyclovir; Antiviral Agents; Common Variable Immunodeficiency; Diagnosis, Differential; Female; Humans; Immunocompromised Host; Lichen Planus, Oral; Middle Aged; Opportunistic Infections; Stomatitis, Herpetic; Valacyclovir; Valine

Intracranial aneurysms in the pediatric population are relatively rare entities. Immunocompromised patients (often from HIV/AIDS or pharmacological immunosuppression) represent a significant fraction of children with cerebral aneurysms. One proposed mechanism of aneurysm formation in these patients is from direct infection of the affected arteries. In this study, the authors report on a case of a 14-year-old girl with common variable immunodeficiency with T-cell dysfunction and a CSF polymerase chain reaction test positive for varicella-zoster virus who underwent evaluation for carotid and basilar artery fusiform aneurysms.

Topics: Acyclovir; Adolescent; Aneurysm; Angiography, Digital Subtraction; Antiviral Agents; Aspirin; Basilar Artery; Carotid Artery Diseases; Carotid Artery, Internal; Cerebral Angiography; Common Variable Immunodeficiency; Female; Herpes Zoster; Humans; Image Processing, Computer-Assisted; Intracranial Aneurysm; Magnetic Resonance Angiography; Platelet Aggregation Inhibitors; T-Lymphocytes; Tomography, X-Ray Computed; Valacyclovir; Valine; Vasculitis; Vertebral Artery

Large papillomatous lesions clinically resembling verrucous carcinoma may be caused by viruses other than human papillomavirus. We report a case of recurrent vegetations covering the entire vulva in a pregnant patient with common variable immunodeficiency. Herpes simplex virus was recovered from these lesions. The patient did not respond to intravenous acyclovir, but her lesions dramatically healed with two courses of intravenous foscarnet. Repeated biopsies may prove necessary in cases such as this to ensure proper diagnoses.

Topics: Acyclovir; Adult; Biopsy; Common Variable Immunodeficiency; Drug Resistance, Microbial; Female; Fetal Death; Foscarnet; Herpes Genitalis; Herpesvirus 2, Human; Humans; Infant, Newborn; Opportunistic Infections; Pregnancy; Pregnancy Complications, Infectious; Recurrence

Topics: Acyclovir; B-Lymphocytes; Chickenpox; Common Variable Immunodeficiency; Humans; Hypergammaglobulinemia; Immunoglobulin A; Immunoglobulin M; Immunoglobulins, Intravenous; Infant; Male; Paraproteins